TY - JOUR
KW - Adult
KW - Buprenorphine/administration & dosage
KW - Delivery of Health Care, Integrated/legislation & jurisprudence/organization & administration
KW - Electronic Health Records
KW - Female
KW - Health Services Accessibility/legislation & jurisprudence
KW - Humans
KW - Logistic Models
KW - Male
KW - Marijuana Abuse/rehabilitation
KW - Middle Aged
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/rehabilitation
KW - Patient Protection and Affordable Care Act
KW - Affordable Care Act
KW - buprenorphine
KW - Health services utilization
AU - Cynthia I. Campbell
AU - Sujaya Parthasarathy
AU - Kelly C. Young-Wolff
AU - Derek D. Satre
A1 - 
AB - The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258). Logistic and negative binomial regressions were used to model persistent buprenorphine use, and to examine whether persistent use was related to health services utilization. Buprenorphine patients were largely similar pre- and post-ACA, although more post-ACA patients had a marijuana use disorder (p < .01). Post-ACA patients were more likely to have high-deductible benefit plans (p < .01). Use of psychiatry services was lower post-ACA (IRR: 0.56, p < .01), and high-deductible plans were also related to lower use of psychiatry services (IRR: 0.30, p < .01). The relationship between marijuana use disorder and prescription opioid use is complex, and deserves further study, particularly with increasingly widespread marijuana legalization. Access to psychiatry services may be more challenging for buprenorphine patients post-ACA, especially for patients with deductible plans.
AD - a Research Scientist, Division of Research , Kaiser Permanente Northern California Region , Oakland , CA , USA.; b Economist, Division of Research , Kaiser Permanente Northern California Region , Oakland , CA , USA.; a Research Scientist, Division of Research , Kaiser Permanente Northern California Region , Oakland , CA , USA.; c Associate Professor, Department of Psychiatry , UCSF Weill Institute for Neurosciences, University of California, San Francisco , San Francisco , CA , USA.
BT - Journal of psychoactive drugs
C5 - Financing & Sustainability; Healthcare Disparities; Healthcare Policy; Opioids & Substance Use
CP - 2
CY - United States
DO - 10.1080/02791072.2017.1305519
IS - 2
JF - Journal of psychoactive drugs
LA - eng
M1 - Journal Article
N2 - The Affordable Care Act (ACA) was expected to benefit patients with substance use disorders, including opioid use disorders (OUDs). This study examined buprenorphine use and health services utilization by patients with OUDs pre- and post-ACA in a large health care system. Using electronic health record data, we examined demographic and clinical characteristics (substance use, psychiatric and medical conditions) of two patient cohorts using buprenorphine: those newly enrolled in 2012 ("pre-ACA," N = 204) and in 2014 ("post-ACA," N = 258). Logistic and negative binomial regressions were used to model persistent buprenorphine use, and to examine whether persistent use was related to health services utilization. Buprenorphine patients were largely similar pre- and post-ACA, although more post-ACA patients had a marijuana use disorder (p < .01). Post-ACA patients were more likely to have high-deductible benefit plans (p < .01). Use of psychiatry services was lower post-ACA (IRR: 0.56, p < .01), and high-deductible plans were also related to lower use of psychiatry services (IRR: 0.30, p < .01). The relationship between marijuana use disorder and prescription opioid use is complex, and deserves further study, particularly with increasingly widespread marijuana legalization. Access to psychiatry services may be more challenging for buprenorphine patients post-ACA, especially for patients with deductible plans.
PP - United States
PY - 2017
SN - 2159-9777; 0279-1072
SP - 160
EP - 168
EP - 
T1 - Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System
T2 - Journal of psychoactive drugs
TI - Buprenorphine Treatment and Patient Use of Health Services after the Affordable Care Act in an Integrated Health Care System
U1 - Financing & Sustainability; Healthcare Disparities; Healthcare Policy; Opioids & Substance Use
U2 - 28426332
U3 - 10.1080/02791072.2017.1305519
VL - 49
VO - 2159-9777; 0279-1072
Y1 - 2017
Y2 - Apr-Jun
ER -